Doctors, partitocrazia, and the Italian state

Political and economic forces are determinants of the social position of the professions in any country, but in Italy the political parties exercise such extensive control that no profession can function independent of political party decision making. The medical profession thus developed in close connection with the state, reflecting in the split between generalists and specialists with its professional organization (ordini) differences between the political parties. The attempt of the state to rationalize the health system and control costs through the mechanism of the Italian national health service had the ironic effect of unifying the profession in opposition and thereby increasing its strength. The case of Italy shows the standard conceptual models of professional autonomy to be incomplete because they fail to account for the central role of political parties.